When York County received $40 million from the American Rescue Plan Act, officials were faced with a tough question: How should they spend a once-in-a-lifetime pot of money that is nearly double the county’s annual budget?

After months of discussion and public hearings, they’re now moving forward with plans to use nearly half of that money, about $17 million, to build a 58-bed recovery center they say will fill a critical need in a county with no detox beds and limited access to substance use treatment. When it opens, York County will become the first county in Maine to operate a recovery center.

“For the county to take an initiative like this on is major and would be a phenomenal model for the rest of the state,” said Kennebunk Police Chief Robert MacKenzie. “We have to do something drastic in order to really make the change needed around substance use. There aren’t nearly enough services out there and there are a lot of people who are hurting.”

Maine has been dealing with a persistent and unrelenting opioid epidemic for years. In 2021, 636 people died from a drug overdose, a 23% increase from the record set in 2020. Experts say the rise in deaths stems from fentanyl being laced into other drugs without the users’ knowledge, along with people feeling increasingly isolated and other challenges stemming from the pandemic.

In York County, there were 70 suspected or confirmed fatal overdoses in 2021, that number has already risen to 73 from January to September 2022, with seven in September alone, according to the most recent data kept by the University of Maine’s Drug Data Hub.

Law enforcement officials say the vast majority of people incarcerated at the county jail have some type of substance use disorder. Last year, the sheriff’s office and local health care providers started handing out harm reduction bags that include fentanyl test strips and naloxone, the opioid overdose reversal medication.

But there also are people outside of the criminal justice system who are struggling and need more access to treatment, said York County Manager Gregory Zinser.

“The problem is more widespread than people realize,” he said. “These are brothers and sisters, sons and daughters, moms and dads.”

‘A GAME-CHANGER’

Gordon Smith, Maine’s director of opioid response, said the idea of a public entity like a county operating its own substance use facility is unprecedented in Maine and an exciting model for others to consider. While several counties are using some of their ARPA funds to support agencies and programs that offer substance use treatment, none are doing so on the same scale as York County.

“This is a game-changer down there,” he said.

The new recovery center in Alfred will be open to anyone in the county and offer a full continuum of care, from detox beds to short-term and long-term recovery programs, said Jen Ouellette, a clinical consultant who helped develop the plans. The recovery center also will include outpatient programs and case management. The county is exploring a partnership with Sanford Housing Authority to provide housing options.

The inclusion of eight observation beds in the new facility is seen by county leaders as a critical component to address an unmet need in the county. Observation beds are used to evaluate what level of care people need.

“If you talk to folks at the state and from local police departments, the issue at the end of the day is there is no place to bring them,” Zinser said. “That’s the relief valve this will be creating in York County.”

When deputies or police officers in York County encounter someone with substance use disorder who wants help, they often have no place to bring them to detox, said Sheriff Bill King. There are no detox beds in York County and those at Milestone Recovery in Portland and other high-demand counties are often unavailable. Those people are unable to enter a treatment program until they have detoxed, which can take days, he said.

MacKenzie, the Kennebunk police chief, said it is critical that treatment be available for people as soon as they ask for help.

“If there’s nothing available at that moment, you may have lost it. People are ready when they’re ready,” he said. “If you don’t have a place to take them, the person could be at risk of overdosing.”

‘GENERATIONAL CHANGE’

In Cumberland County, officials will use its $57.3 million ARPA allocation for a slew of projects and programs, including a new medical wing at the county jail and efforts to address homelessness. Funding also will be distributed to municipalities and agencies through grants to address affordable housing, child care, substance use treatment and public health.

Kennebec County made a substantial contribution from its ARPA funds to a recovery and reentry center in Augusta. And in Penobscot County, $25,000 grants were awarded to four recovery centers, Smith said.

York County has been working to address the opioid epidemic since 2018 when it collaborated with the district attorney’s office and York County Shelter Programs to open the Layman Way Recovery Center, a 24-bed addiction treatment program for people in the criminal justice system. Zinser said the program, funded through taxes, has successfully offered treatment to people who might otherwise be facing jail time for non-violent crimes.

But that program is not open to all residents and doesn’t adequately address the ongoing problems of substance use disorder and overdoses in the community, Zinser said.

County commissioners saw the same need and during public hearings, residents from the 29 towns and cities in the county asked for more resources, said Al Sicard, chairman of the commissioners.

“We see this $40 million (from ARPA) as a once-in-a-lifetime opportunity to do something that will have generational change,” he said.

Zinser estimates it will cost about $17 million to build the new recovery center on the same county-owned campus near the jail. He anticipates construction could begin as early as next spring and take 17 to 19 months. It will be run by a staff of 80 and cost around $6 million a year to operate. MaineCare reimbursements are expected to cover close to $5 million annually, with other funding coming from county taxes.